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Health-insurance Coverage for Low-wage Workers, 1979-2010 and Beyond

Health-insurance Coverage for Low-wage Workers, 1979-2010 and Beyond

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This paper uses data from the Current Population Surveys for 1980 through 2011 to review trends in health-insurance coverage rates for low-wage workers (defined as workers in the bottom fifth of the wage distribution in each survey year). In 2010, over 38 percent of low-wage workers lacked health insurance from any source, up from 16 percent in 1979. The biggest reason for the decline in coverage is the erosion of employer-provided health insurance, either through a worker's own employer or as a dependent on another family member's employer-provided policy. Over the last three decades, the role of public insurance in providing coverage for low-wage workers has increased, though not nearly enough to offset the declines in private insurance. In 2010, about 10 percent of low-wage workers had coverage through Medicaid, double the share in 1979. While a great deal of uncertainty still surrounds the Affordable Care Act (ACA) and its likely impact on employers and workers, reasonable estimates based on consensus projections suggest that the ACA will have a substantial positive effect on health-insurance coverage rates for low-wage workers. Even so, the ACA will likely leave an important share of low-wage workers, especially low-wage Latino, African American, and Asian workers, as well as many immigrant workers, without coverage. At the same time, if the ACA is blocked – in the courts or in Congress – there is every indication that coverage rates for low-wage workers will continue their long, steady decline.
This paper uses data from the Current Population Surveys for 1980 through 2011 to review trends in health-insurance coverage rates for low-wage workers (defined as workers in the bottom fifth of the wage distribution in each survey year). In 2010, over 38 percent of low-wage workers lacked health insurance from any source, up from 16 percent in 1979. The biggest reason for the decline in coverage is the erosion of employer-provided health insurance, either through a worker's own employer or as a dependent on another family member's employer-provided policy. Over the last three decades, the role of public insurance in providing coverage for low-wage workers has increased, though not nearly enough to offset the declines in private insurance. In 2010, about 10 percent of low-wage workers had coverage through Medicaid, double the share in 1979. While a great deal of uncertainty still surrounds the Affordable Care Act (ACA) and its likely impact on employers and workers, reasonable estimates based on consensus projections suggest that the ACA will have a substantial positive effect on health-insurance coverage rates for low-wage workers. Even so, the ACA will likely leave an important share of low-wage workers, especially low-wage Latino, African American, and Asian workers, as well as many immigrant workers, without coverage. At the same time, if the ACA is blocked – in the courts or in Congress – there is every indication that coverage rates for low-wage workers will continue their long, steady decline.

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Published by: Center for Economic and Policy Research on Feb 22, 2012
Copyright:Attribution Non-commercial

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10/16/2012

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 This paper was prepared for
the conference on “
 What Works for Workers?Public Policies and Innovative Strategies for Low-Wage Workers
,”
sponsored by  The Kalmanovitz Initiative on Labor and the Working Poor, GeorgetownUniversity and The Joseph S. Murphy Institute for Worker Education and LaborStudies, CUNY, at Georgetown University, February 23-24, 2012.
 
Health-insurance Coverage for Low-wage Workers, 1979-2010 and Beyond
 John Schmitt
February 2012
 
 
CEPR Health-insurance Coverage for Low-wage Workers, 1979-2010 and Beyond
i
 About the Author
 John Schmitt is a Senior Economist at the Center for Economic and Policy Research in Washington,D.C.
 Acknowledgments
 The author thanks Eileen Appelbaum, Dean Baker, and Nicole Woo for helpful comments and Alexandra Mitukiewicz and Janelle Jones for research assistance.
Contents
 
CEPR Health-insurance Coverage for Low-wage Workers, 1979-2010 and Beyond
1
Abstract
 This paper uses data from the Current Population Surveys for 1980 through 2011 to review trendsin health-insurance coverage rates for low-wage workers (defined as workers in the bottom fifth of the wage distribution in each survey year). In 2010, over 38 percent of low-wage workers lackedhealth insurance from any source, up from 16 percent in 1979. The biggest reason for the decline incoverage is the erosion of employer-provided health insurance, either through a worker
s ownemployer or as a dependent on another family member
s employer-provided policy. Over the lastthree decades, the role of public insurance in providing coverage for low-wage workers hasincreased, though not nearly enough to offset the declines in private insurance. In 2010, about 10percent of low-wage workers had coverage through Medicaid, double the share in 1979. While agreat deal of uncertainty still surrounds the Affordable Care Act (ACA) and its likely impact onemployers and workers, reasonable estimates based on consensus projections suggest that the ACA will have a substantial positive effect on health-insurance coverage rates for low-wage workers. Evenso, the ACA will likely leave an important share of low-wage workers, especially low-wage Latino, African American, and Asian workers, as well as many immigrant workers, without coverage. At thesame time, if the ACA is blocked
 – 
in the courts or in Congress
 – 
there is every indication thatcoverage rates for low-wage workers will continue their long, steady decline.

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